{
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"FirstLineMailingAddress": "21 KINGSWOOD RD",
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"MailingAddressCityName": "BRANCHBURG",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "08876-7428",
"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "3322 ROUTE 22",
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"EnumerationDate": "04/11/2017",
"LastUpdateDate": "03/02/2018",
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "BLOOM",
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"AuthorizedOfficialCredential": "LCSW",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Clinical Social Worker",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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}
}
}
}